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1.
Ned Tijdschr Geneeskd ; 1652021 02 16.
Article in Dutch | MEDLINE | ID: mdl-33651518

ABSTRACT

Awake prone positioning in COVID-19 patients with respiratory failure has been applied worldwide. We hypothesize that early intervention of awake prone positioning in this patient category might avoid invasive mechanical ventilation and referral to ICU. We observed approximately 30 patients in Suriname in whom awake prone positioning was applied. Also, we reviewed the existing literature on awake prone positioning and discussion of the advantages and disadvantages of this relatively simple intervention. Prospective studies show an improvement in oxygenation, albeit sometimes temporary, but not a reduction in mortality rate or intubation. Mean duration of symptoms in these studies is 10-11 days. Awake prone positioning in COVID-19 patients with a longer duration of symptoms does not improve survival or need for intubation. No prospective studies on early prone position in COVID-19 patients have been conducted yet.


Subject(s)
/complications , Patient Positioning/methods , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy , Wakefulness , /physiopathology , Humans , Lung/physiopathology , Male , Prone Position , Prospective Studies , Respiratory Insufficiency/physiopathology , Suriname , Time Factors
2.
Fontilles, Rev. leprol ; 32(6): 411-439, sept.-dic. 2020. mapas, tab, ilus
Article in Spanish | IBECS | ID: ibc-199932

ABSTRACT

Los colonizadores holandeses en Surinam afirmaban que la lepra (o enfermedad de Hansen) era muy contagiosa y se transmitía entre humanos. Se construyó un "cordón sanitario" alrededor de los pacientes, sobre todo esclavos africanos y asiáticos contratados como trabajadores y sus descendientes. Se les perseguía y eran recluidos en aldeas para afectados de lepra muy remotas localizadas en la selva tropical. Algunos pacientes obedecieron a las autoridades, mientras que otros resistieron y se rebelaron. Sus historias revelan conceptos confusos sobre la enfermedad con su cultura y el medioambiente surinamés, y contienen importantes informaciones para comprender su mundo y la vida dentro y fuera de las colonias para lepra. Combinaban prácticas sanitarias tradicionales y plantas medicinales de su hábitat natural con tratamientos biomédicos (practicando un pluralismo médico). Creían en una gran variedad de explicaciones sobre la enfermedad, predominantemente los conceptos tabúes treef, tyina y animales tótem asociados con su hábitat natural (el bioma surinamés). Algunas de las explicaciones de su imaginario (por ejemplo, la lepra es transmitida por la tierra y ciertos animales) revelan una analogía sorprendente con descubrimientos científicos recientes. Nuestra investigación revela que la naturaleza contribuye a moldear el mundo de los pacientes de Hansen. Un planteamiento ecológico puede contribuir significativamente a la hora de comprender su mundo. Hay que efectuar una investigación histórica y antropológica comparativa para trazar la influencia de distintos biomas sobre los modelos locales. Las colonias de Hansen actualmente abandonadas y sus entornos naturales son lugares importantes para el patrimonio cultural


According to the Dutch colonizers in Suriname, leprosy (or Hansen's disease) was highly contagious and transmitted from human-to-human. A "cordon sanitaire" was constructed around the patients, mainly African slaves and Asian indentured laborers and their descendants. They were tracked down and incarcerated in remote leprosy settlements located in the rainforest. Some patients obeyed the authorities while others resisted and rebelled. Their narratives, revealing conceptual entanglement of the disease with their culture and the Surinamese natural environment, contain important information for understanding their world and their life inside and outside of leprosy settlements. They combined traditional health practices and medicinal plants from their natural habitat with biomedical treatments (practicing medical pluralism). They believed in a diversity of disease explanations, predominantly the taboo concepts treef, tyina, and totem animals associated with their natural habitat (the Surinamese biome). Some of their imaginary explanations (e.g., "leprosy is carried and/or transmitted through soil and certain animals") show a surprising analogy with recent findings from leprosy scientists. Our research shows that nature contributes to shaping the world of Hansen's disease patients. An ecological approach can make a valuable contribution to understanding their world. Comparative historical and anthropological research needs to be conducted to map the influence of different biomes on local explanatory models. The now deserted Hansen's disease settlements and their natural environments are interesting research sites and important places of cultural heritage


Subject(s)
Humans , History, 18th Century , History, 19th Century , History, 20th Century , Leprosy/history , Colonialism/history , Leprosy/prevention & control , Leprosy/therapy , Interviews as Topic , Socioeconomic Factors , Patients/psychology , Cultural Characteristics , Suriname/ethnology , Hospitals, Isolation/history , Quarantine/history , Patient Isolation/history
3.
Zootaxa ; 4881(3): zootaxa.4881.3.2, 2020 Nov 20.
Article in English | MEDLINE | ID: mdl-33311300

ABSTRACT

The known cicada fauna of Suriname is identified. Zammara guyanensis n. sp., and Proarna proximorubrovenosa n. sp. are described as new. The taxa Zammara eximia Erichson, 1848, Cicada thalassina Germar, 1830, Cicadetta surinamensis (Kirkaldy, 1909), Cicada collaris Degeer, 1773 and Cicada melanoptera Gmelin, 1789 (=Cicada marginata Degeer, 1773) are reassigned to become Zammaralna eximia (Erichson, 1848) n. comb., Hyantia thalassina (Germar, 1830) n. comb., Taphura surinamensis (Kirkaldy, 1909) n. comb., Alocha collaris (Degeer, 1773) n. comb. (Cicadellidae: Cicadellinae: Cicadellini), and Homalodisca melaoptera (Gmelin, 1789) n. comb. (Cicadellidae: Cicadellinae: Proconiini), respectively. The first records of Fidicina christinae Boulard Martinelli, 1996, Guyalna bicolor (Olivier, 1790), and Majeorona truncata Goding, 1925 are provided. Included are the first Suriname records for the genera Guyalna Boulard Martinelli, 1996, Majeorona Distant, 1905c, and Hyantia Stål, 1866. The taxon Neotibicen tibicen tibicen (Linnaeus, 1758) is removed from the fauna of Suriname with references to this taxon considered misidentifications of Fidicina mannifera (Fabricius, 1803). Cicada collaris Degeer, 1773, and Cicada melanoptera Gmelin, 1789 (=Cicada marginata Degeer, 1773) are reassigned to the Cicadellidae and also removed from the cicada faunal list. The currently known cicada fauna of Suriname is comprised of 15 species from nine genera, three tribes and two subfamilies. The known cicada fauna diversity is increased 50% with this work.


Subject(s)
Hemiptera , Animals , Suriname
4.
PLoS One ; 15(12): e0244087, 2020.
Article in English | MEDLINE | ID: mdl-33338049

ABSTRACT

BACKGROUND: Postpartum hemorrhage (PPH) is the leading cause of direct maternal mortality globally and in Suriname. We aimed to study the prevalence, risk indicators, causes, and management of PPH to identify opportunities for PPH reduction. METHODS: A nationwide retrospective descriptive study of all hospital deliveries in Suriname in 2017 was performed. Logistic regression analysis was applied to identify risk indicators for PPH (≥ 500ml blood loss). Management of severe PPH (blood loss ≥1,000ml or ≥500ml with hypotension or at least three transfusions) was evaluated via a criteria-based audit using the national guideline. RESULTS: In 2017, the prevalence of PPH and severe PPH in Suriname was 9.2% (n = 808/8,747) and 2.5% (n = 220/8,747), respectively. PPH varied from 5.8% to 15.8% across the hospitals. Risk indicators associated with severe PPH included being of African descent (Maroon aOR 2.1[95%CI 1.3-3.3], Creole aOR 1.8[95%CI 1.1-3.0]), multiple pregnancy (aOR 3.4[95%CI 1.7-7.1]), delivery in Hospital D (aOR 2.4[95%CI 1.7-3.4]), cesarean section (aOR 3.9[95%CI 2.9-5.3]), stillbirth (aOR 6.4 [95%CI 3.4-12.2]), preterm birth (aOR 2.1[95%CI 1.3-3.2]), and macrosomia (aOR 2.8 [95%CI 1.5-5.0]). Uterine atony (56.7%, n = 102/180[missing 40]) and retained placenta (19.4%, n = 35/180[missing 40]), were the main causes of severe PPH. A criteria-based audit revealed that women with severe PPH received prophylactic oxytocin in 61.3% (n = 95/155[missing 65]), oxytocin treatment in 68.8% (n = 106/154[missing 66]), and tranexamic acid in 4.9% (n = 5/103[missing 117]). CONCLUSIONS: PPH prevalence and risk indicators in Suriname were similar to international and regional reports. Inconsistent blood loss measurement, varied maternal and perinatal characteristics, and variable guideline adherence contributed to interhospital prevalence variation. PPH reduction in Suriname can be achieved through prevention by practicing active management of the third stage of labor in every birth and considering risk factors, early recognition by objective and consistent blood loss measurement, and prompt treatment by adequate administration of oxytocin and tranexamic acid according to national guidelines.


Subject(s)
Parturition , Postpartum Hemorrhage/mortality , Premature Birth/mortality , Uterine Inertia/mortality , Adult , Female , Humans , Postpartum Hemorrhage/etiology , Postpartum Hemorrhage/prevention & control , Pregnancy , Premature Birth/prevention & control , Retrospective Studies , Suriname/epidemiology , Uterine Inertia/prevention & control
5.
Zootaxa ; 4820(1): zootaxa.4820.1.7, 2020 Jul 27.
Article in English | MEDLINE | ID: mdl-33056085

ABSTRACT

Anomaloglossus is a species-rich genus of frogs endemic to the Guiana Shield that still harbours several unnamed species. According to a recent integrative taxonomic survey, the A. stepheni species group includes five valid nominal species and at least four putatively unnamed species, two in Brazil and two in Suriname. In this paper, we describe the two species from Suriname based on adult and tadpole morphology as well as their calls and natural history. Both have exotrophic tadpoles transported by the male to small water bodies. These two new species differ from each other and from other congeners in body size, colouration pattern, call characteristics and breeding sites. Both have narrow distributions and should be considered Endangered according to IUCN criteria.


Subject(s)
Anura , Animals , Larva , Male , Suriname
6.
Am J Trop Med Hyg ; 103(4): 1711-1716, 2020 10.
Article in English | MEDLINE | ID: mdl-32662397

ABSTRACT

Venomous snakebites regularly occur in Suriname, a middle-income country located on the north coast of South America. Officially reported data on incidence and mortality are lacking. The aim of this retrospective study was to assess whether the use of our national snakebite protocol with selective administration of anti-snake venom (ASV) in patients with signs of snakebite envenoming improved clinical outcome as measured by mortality and length of stay (LOS) in the hospital. Medical records of all patients admitted at the Academic Hospital Paramaribo from 2013 to 2015, before and after the introduction of the protocol, with signs of snakebite envenoming, were reviewed for demographics, snakebite characteristics, mortality, length of hospital stay, administration of ASV, and occurrence of complications. Secondary outcome measures were the development of late complications due to a snakebite. Sixty-eight and 76 patients in 2013 and 2015, respectively, with venomous or potentially venomous snakebites were identified. One patient (1.5%) in 2013 and 29 patients (38.2%) in 2015 received ASV. In 2013 one patient died: deterioration of renal function occurred before protocolled ASV administration. No deaths were reported in 2015. There was no difference in the overall length of hospital stay between 2013 and 2015 or in the total number of late complications. In 2015, the mean LOS (±SD) for patients who did not receive ASV (n = 47) was significantly lower than that for patients who received ASV (n = 29), 2.15 ± 2.27 versus 5.31 ± 5.53 days, respectively (P = 0.001). The mean LOS (±SD) for patients who did not receive ASV in 2013 (n = 67) and 2015 (n = 47) was 4.06 ± 5.44 and 2.15 ± 2.27 days, respectively, which also differed significantly (P = 0.025). The protocolled evaluation of snakebite victims resulted in more patients being admitted to the intensive care unit and receiving ASV and a shorter length of hospital stay for the patients who did not receive ASV, and no difference in the occurrence of complications was observed in Suriname's largest hospital responsible for the acute care of snakebite victims.


Subject(s)
Snake Bites/drug therapy , Snake Venoms/therapeutic use , Adult , Female , Humans , Incidence , Length of Stay , Male , Middle Aged , Retrospective Studies , Snake Bites/epidemiology , Snake Bites/mortality , Suriname/epidemiology , Tertiary Healthcare , Young Adult
7.
Article in English | MEDLINE | ID: mdl-32575788

ABSTRACT

Prenatal exposure to mercury, stress, and depression may have adverse effects on birth outcomes. Little is known on the influence of chemical and non-chemical stressors on birth outcomes in the country of Suriname. We assessed the influence of prenatal exposure to mercury, perceived stress, and depression on adverse birth outcomes in 1143 pregnant Surinamese women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study. Associations between mercury (≥1.1 µg/g hair, USEPA action level/top versus bottom quartile), probable depression (Edinburgh Depression Scale ≥12), high perceived stress (Cohen's Perceived Stress Scale ≥20), and adverse birth outcomes (low birthweight (<2500 g), preterm birth (<37 completed weeks of gestation), and low Apgar score (<7 at 5 min)) were assessed using bivariate and multivariate logistic regressions. Prevalence of elevated mercury levels, high perceived stress, and probable depression were 37.5%, 27.2%, and 22.4%, respectively. Mercury exposure was significantly associated with preterm birth in the overall study cohort (OR 2.47; 95% CI 1.05-5.83) and perceived stress with a low Apgar score (OR 9.73; 95% CI 2.03-46.70). Depression was not associated with any birth outcomes. These findings can inform policy- and practice-oriented solutions to improve maternal and child health in Suriname.


Subject(s)
Depression , Mercury , Premature Birth , Prenatal Exposure Delayed Effects , Stress, Psychological , Adult , Caribbean Region , Child , Female , Humans , Infant, Newborn , Mercury/toxicity , Pregnancy , Prospective Studies , Suriname , Young Adult
8.
Article in English | MEDLINE | ID: mdl-32517037

ABSTRACT

Prenatal mercury (Hg) exposure was determined in a sub-cohort of the Caribbean Consortium for Environmental and Occupational Health's environmental epidemiologic prospective cohort study of pregnant women living in Suriname's interior. The associations between Hg exposure, low birth weight (LBW, <2500 g) and preterm birth (PTB, <37 weeks) were explored. Correlation analysis, Fisher's exact test and logistic regression analyses were conducted to evaluate the associations between maternal hair Hg levels and birth weight, LBW and PTB, and between potential confounders, LBW and PTB, respectively. Among 204 singleton births were 198 live births, five stillbirths and one miscarriage. The mean participant age was 26 years; 15.7% of participants had PTBs and 8.1% delivered a child with a LBW. The median hair Hg level was 3.48 µg/g hair. Low hair Hg exposure, based on lowest tertile < 2.34 µg/g, was associated with LBW (OR = 7.2; 95% CI 1.5-35.6; p = 0.015); this association was independent of maternal age, ethnic background, household income and village location, and no correlation was found between hair Hg and PTB. Young maternal age was associated with PTB (RR = 5.09, 95% CI: 1.92-13.85; p = 0.0004) while maternal age was not associated with hair Hg or LBW. The impact of prenatal Hg exposure on pediatric neurodevelopment is currently being evaluated in the infant sub-cohort.


Subject(s)
Maternal Exposure/statistics & numerical data , Mercury , Pregnancy Outcome/epidemiology , Premature Birth , Caribbean Region , Child , Female , Humans , Infant, Low Birth Weight , Infant, Newborn , Pregnancy , Prospective Studies , Suriname/epidemiology
9.
PLoS One ; 15(3): e0230288, 2020.
Article in English | MEDLINE | ID: mdl-32160272

ABSTRACT

BACKGROUND: Treponema pallidum subspecies pallidum (TPA) and subsp. endemicum (TEN) are the causative agents of syphilis and bejel, respectively. TEN shows similar clinical manifestations and is morphologically and serologically indistinguishable from TPA. Recently, bejel was found outside of its assumed endemic areas. Using molecular typing we aimed to discover bejel and characterize circulating TPA types among syphilis cases with Surinamese, Antillean and Dutch ethnicity in Amsterdam. METHODS: DNA was extracted from 137 ulcer swabs, which tested positive in the in-house diagnostic PCR targeting the polA gene. Samples were collected between 2006 and 2018 from Surinamese, Antillean and Dutch patients attending the Amsterdam STI clinic. Multilocus sequence typing was performed by partial sequence analysis of the tp0136, tp0548 and tp0705 genes. In addition, the 23S rRNA loci were analyzed for A2058G and A2059G macrolide resistance mutations. RESULTS: We found 17 distinct allelic profiles in 103/137 (75%) fully typed samples, which were all TPA and none TEN. Of the strains, 82.5% were SS14-like and 17.5% Nichols-like. The prevalence of Nichols-like strains found in this study is relatively high compared to nearby countries. The most prevalent types were 1.3.1 (42%) and 1.1.1 (19%), in concordance with similar TPA typing studies. The majority of the TPA types found were unique per country. New allelic types (7) and profiles (10) were found. The successfully sequenced 23S rRNA loci from 123/137 (90%) samples showed the presence of 79% A2058G and 2% A2059G mutations. CONCLUSIONS: No TEN was found in the samples from different ethnicities residing in Amsterdam, the Netherlands, so no misdiagnoses occurred. Bejel has thus not (yet) spread as a sexually transmitted disease in the Netherlands. The strain diversity found in this study reflects the local male STI clinic population which is a diverse, mixed group.


Subject(s)
Genes, Bacterial , Syphilis/microbiology , Treponema pallidum/genetics , Adult , Alleles , DNA Barcoding, Taxonomic , Ethnic Groups/statistics & numerical data , Humans , Netherlands , Netherlands Antilles , Suriname , Syphilis/epidemiology , Syphilis/ethnology , Treponema pallidum/classification , Treponema pallidum/pathogenicity
10.
Parasit Vectors ; 13(1): 121, 2020 Mar 06.
Article in English | MEDLINE | ID: mdl-32143711

ABSTRACT

BACKGROUND: Emerging arboviral diseases like Zika, dengue and chikungunya that are transmitted by Aedes aegypti mosquitoes, are increasingly threatening human health. Blends of human-like synthetic chemical attractants can be used to attract host-seeking mosquitoes. The aim of this study was to test new combinations of traps and odour baits in the laboratory, followed by testing the best candidates in the field to improve Ae. aegypti monitoring and surveillance. METHODS: First, the BG-Suna trap was evaluated for capturing laboratory-reared Ae. aegypti by testing normal and inverted positions in screen cage tests. Secondly, the attractiveness of the MB5 blend, CO2, and their combination was tested. Thirdly, we tested the attractiveness of different trap types (BG-Suna, BG-Sentinel, MM-X and CDC light trap). Finally, we confirmed laboratory results in the field in Paramaribo, Suriname, using the MB5 and BG-Lure odour blends, CO2 and the BG-Sentinel and BG-Bowl trap using a Latin Square design. RESULTS: The MB5 blend in combination with CO2 outperformed traps baited only with CO2 or MB5 in screen cage tests (P < 0.0001). The BG-Sentinel trap performed equally well as the inverted BG-Suna and was taken to the field (P = 0.729). In the field, we captured Ae. aegypti, Cx. quinquefasciatus and Cx. nigripalpus. We confirmed the laboratory results and found that the combination of the MB5 blend and CO2 almost doubled Ae. aegypti female captures (P = 0.004) and more than doubled Culex spp. female captures (P = 0.005) compared to using only CO2. Interestingly, the MB5 blend outperformed the commercially available BG-Lure, in the BG-Sentinel (P < 0.001). The BG-Bowl also attracted Ae. aegypti when baited with the MB5 blend in similar numbers as the BG-Sentinel baited with the MB5 (P = 0.362). CONCLUSIONS: Our study demonstrated that the BG-Sentinel trap baited with the MB5 blend and CO2 outperforms the current golden standard (BG-Sentinel trap with BG-Lure) for monitoring Ae. aegypti females and males, in both laboratory and field experiments. The BG-Bowl baited with the MB5 blend is a good candidate for home use. Finally, the results show that CO2 is an indispensable component of the attractive blend.


Subject(s)
Behavior, Animal/physiology , Mosquito Control/methods , Mosquito Vectors/physiology , Odorants , Aedes/physiology , Animals , Carbon Dioxide/pharmacology , Culex , Male , Mosquito Control/instrumentation , Pheromones , Suriname
11.
Article in English | MEDLINE | ID: mdl-32098351

ABSTRACT

This paper describes efforts by public health practitioners to address a health crisis caused by economic development policies that are unrestrained by either environmental, public health, or human rights mandates. Economic development projects funded by international funding institutions like the Inter-American Development Bank that reduce poverty when measured in terms of Gross Domestic Product (GDP) per capita in the transborder region between Suriname and French Guiana harm minority populations where commercial activities destroy, alter, and remove the resources upon which local communities depend. In this study, the structural causes of a community health crisis affecting Indigenous people in the transborder region between Suriname and French Guiana was addressed by seeking gatekeepers in government who have access to policy-making processes. We found that deeply rooted economic development policies structured social, economic, and political alliances and made them resistant to feedback and reform. We concluded that work must be focused beyond the simple exchange of public health information. Public health practitioners must become politically active to create new policy commitments and new patterns of governance that advance development as well as improve health outcomes. Failure to do so may result in public health practitioners becoming 'engaged followers' that are complicit in the inhumanity that springs from their acquiescence to the authority of government officials when their policies are the cause of preventable death, disease, and disability.


Subject(s)
Diplomacy , Economics , Global Health , Government , Politics , Public Health , Developing Countries/economics , Developing Countries/statistics & numerical data , Global Health/statistics & numerical data , Global Health/trends , Humans , Public Health/statistics & numerical data , Public Policy , Suriname
12.
Curr Diabetes Rev ; 16(6): 641-648, 2020.
Article in English | MEDLINE | ID: mdl-31654516

ABSTRACT

INTRODUCTION: The typical factors precipitating diabetic ketoacidosis (DKA) include infections (30%), cessation of antidiabetic medication (20%), and a new diagnosis of diabetes (25%). The etiology remains unknown in 25% of cases. Less frequent causes cited in the literature include severe thyrotoxicosis and, infrequently, pericarditis. Few publications have described the role of human T lymphotropic virus type 1 (HTLV-1) in endocrine and metabolic disorders. Based on a clinical case associated with several endocrine and metabolic disorders, we suggest a potential role for HTLV-1, an endemic virus in the Amazonian area, and review the literature concerning the role of this virus in thyroiditis, pericarditis and diabetes mellitus. CASE REPORT: A fifty-year-old Surinamese woman without any medical history was admitted for diabetic ketoacidosis. No specific anti-pancreatic autoimmunity was observed, and the C-peptide level was low, indicating atypical type-1 diabetes mellitus. DKA was associated with thyrotoxicosis in the context of thyroiditis and complicated by nonbacterial pericarditis and a Staphylococcus aureus subcutaneous abscess. The patient was infected with HTLV-1. CONCLUSION: To our knowledge, this uncommon association is described for the first time. Few studies have analyzed the implications of HTLV-1 infection in thyroiditis and diabetes mellitus. We did not find any reports describing the association of pericarditis with HTLV-1 infection. Additional studies are necessary to understand the role of HTLV-1 in endocrine and cardiac disorders.


Subject(s)
Abscess/etiology , Deltaretrovirus Infections/complications , Diabetes Mellitus, Type 1/etiology , Diabetic Ketoacidosis/etiology , Pericarditis/etiology , Thyrotoxicosis/etiology , Abscess/immunology , Abscess/microbiology , Acute Disease , Deltaretrovirus Infections/virology , Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 1/virology , Diabetic Ketoacidosis/immunology , Diabetic Ketoacidosis/therapy , Diabetic Ketoacidosis/virology , Female , Human T-lymphotropic virus 1/isolation & purification , Humans , Immunocompetence , Middle Aged , Pericarditis/virology , Staphylococcal Skin Infections/etiology , Staphylococcal Skin Infections/immunology , Staphylococcal Skin Infections/microbiology , Staphylococcus aureus/isolation & purification , Suriname , Systemic Inflammatory Response Syndrome/etiology , Systemic Inflammatory Response Syndrome/immunology , Systemic Inflammatory Response Syndrome/virology , Thyroiditis/virology , Thyrotoxicosis/virology
13.
Orphanet J Rare Dis ; 14(1): 294, 2019 12 19.
Article in English | MEDLINE | ID: mdl-31856865

ABSTRACT

BACKGROUND: Mandibuloacral Dysplasia with type B lipodystrophy (MADB) is a rare premature aging disorder with an autosomal recessive inheritance pattern. MADB is characterized by brittle hair, mottled, atrophic skin, generalized lipodystrophy, insulin resistance, metabolic complications and skeletal features like stunted growth, mandibular and clavicular hypoplasia and acro-osteolysis of the distal phalanges. MADB is caused by reduced activity of the enzyme zinc metalloprotease ZMPSTE24 resulting from compound heterozygous or homozygous mutations in ZMPSTE24. METHODS: In 2012, and again in 2018, eight related patients from the remote tropical rainforest of inland Suriname were analysed for dysmorphic features. DNA analysis was performed and clinical features were documented. We also analysed all previously reported genetically confirmed MADB patients from literature (n = 12) for their clinical features. Based on the features of all cases (n = 20) we defined major criteria as those present in 85-100% of all MADB patients and minor criteria as those present in 70-84% of patients. RESULTS: All the Surinamese patients are of African descent and share the same homozygous c.1196A > G, p.(Tyr399Cys) missense variant in the ZMPSTE24 gene, confirming MADB. Major criteria were found to be: short stature, clavicular hypoplasia, delayed closure of cranial sutures, high palate, mandibular hypoplasia, dental crowding, acro-osteolysis of the distal phalanges, hypoplastic nails, brittle and/or sparse hair, mottled pigmentation, atrophic and sclerodermic skin, and calcified skin nodules. Minor criteria were (generalized or partial) lipoatrophy of the extremities, joint contractures and shortened phalanges. Based on our detailed clinical observations, and a review of previously described cases, we propose that the clinical diagnosis of MADB is highly likely if a patient exhibits ≥4 major clinical criteria OR ≥ 3 major clinical criteria and ≥ 2 minor clinical criteria. CONCLUSIONS: We report on eight related Surinamese patients with MADB due to a homozygous founder mutation in ZMPSTE24. In low-income countries laboratory facilities for molecular genetic testing are scarce or lacking. However, because diagnosing MADB is essential for guiding clinical management and for family counselling, we defined clinical diagnostic criteria and suggest management guidelines.


Subject(s)
Craniofacial Abnormalities/genetics , Lipodystrophy/genetics , Membrane Proteins/genetics , Metalloendopeptidases/genetics , Adolescent , Adult , Child , Child, Preschool , Female , Homozygote , Humans , Male , Mutation/genetics , Pedigree , Phenotype , Suriname , Young Adult
14.
Rev Panam Salud Publica ; 43, December 2019
Article in English | PAHO-IRIS | ID: phr-51755

ABSTRACT

[ABSTRACT]. Objective. To identify socio-demographic and clinical factors associated with mortality among persons with tuberculosis (TB) and TB/HIV co-infection in Suriname. Methods. This was a retrospective cohort study using data from the national TB and HIV databases for 2010 – 2015. The survival probability of TB and TB/HIV co-infected patients was analyzed using the Kaplan-Meier estimates and the log-rank test. A Cox proportional hazard model was applied. Results. The study showed that HIV-seropositivity (aHR: 2.08, 95%CI: 1.48 – 2.92) and older age (aHR: 5.84, 95%CI: 3.00 – 11.4) are statistically associated with higher mortality. For the TB/HIV co-infected patients, TB treatment (aHR: 0.43, 95%CI: 0.35 – 0.53) reduces the risk of death. Similarly, HIV treatment started (aHR: 0.15, 95%CI: 0.12 – 0.19) and delayed (aHR: 0.25, 95%CI: 0.13 – 0.47) result in less hazard for mortality; Directly-Observed Treatment (aOR: 0.16, 95%CI: 0.09 – 0.29) further reduces the risk. Conclusions. The Ministry of Health of Suriname should develop strategies for early case-finding in key populations, such as for HIV and TB in men 60 years of age and older. Implementation of Isoniazid Preventive Therapy for HIV should be pursued. Scaling up TB and HIV treatment, preferably through supervision, are essential to reducing the TB/HIV mortality.


[RESUMEN]. Objetivo. Identificar factores sociodemográficos y clínicos asociados con la mortalidad en personas con tuberculosis (TB) y VIH en Suriname. Métodos. Estudio de cohorte retrospectivo llevado a cabo con información de las bases de datos nacionales de TB y VIH para el período 2010-2015. Se analizó la probabilidad de supervivencia de los pacientes con TB y con coinfección TB/VIH mediante estimaciones de Kaplan-Meier y prueba de log-rank. Se aplicó un modelo de riesgo proporcional de Cox. Resultados. El estudio demostró que la seropositividad al VIH (cociente de riesgos instantáneos ajustado [aHR]: 2,08, IC 95%: 1,48-2,92) y la edad avanzada (aHR: 5,84, IC 95%: 3,00-11,4) están estadísticamente asociados con una mayor mortalidad. En los pacientes coinfectados con TB/VIH, el tratamiento de la TB (aHR: 0,43, IC 95%: 0,35-0,53) disminuye el riesgo de muerte. Del mismo modo, el inicio (dentro de 56 días) del tratamiento antirretroviral (aHR: 0,15, IC 95%: 0,12-0,19) y retrasado (aHR: 0,25, IC 95%: 0,13-0,47) conllevan un menor riesgo de mortalidad; el tratamiento directamente observado (aOR: 0,16, IC 95%: 0,09- 0,29) reduce aún más el riesgo. Conclusiones. El Ministerio de Salud de Suriname debe desarrollar estrategias para la búsqueda temprana de casos de TB y VIH en poblaciones clave, como en los varones de 60 años de edad o mayores. Debería establecerse el tratamiento preventivo con isoniazida en las personas con VIH. A fin de reducir la mortalidad debida a la TB y el VIH es esencial ampliar el tratamiento de ambas enfermedades, preferiblemente de manera supervisada.


[RESUMO]. Objetivo. Identificar fatores sociodemográficos e clínicos associados à mortalidade em pessoas com tuberculose (TB) e coinfecção pelo vírus da imunodeficiência humana (HIV) no Suriname. Métodos. Foi realizado um estudo de coorte retrospectivo. As informações foram obtidas das bases de dados nacionais de TB e HIV para o período de 2010 a 2015. A probabilidade de sobrevida dos pacientes com coinfecção por TB/HIV foi analisada a partir de estimativas de Kaplan-Meier e pelo teste log-rank. Um modelo de riscos proporcionais de Cox foi aplicado. Resultados. O estudo mostrou que soropositividade para o HIV (adjusted hazard ratio [aHR]: 2,08; IC95%: 1,48 a 2,92) e idade avançada (aHR: 5,84; IC95%: 3,00 a 11,4) foram estatisticamente associadas a maior mortalidade. Em pacientes coinfectados por TB e HIV, o tratamento da TB (aHR: 0,43; IC95%: 0,35 a 0,53) reduziu o risco de morte. Da mesma forma, o tratamento do HIV iniciado (em 56 dias) (aHR: 0,15; IC95%: 0,12 a 0,19) e retardado (aHR: 0,25; IC95%: 0,13 a 0,47) resultou em menor risco de mortalidade. O tratamento diretamente observado da tuberculose (aOR: 0,16; IC 95%: 0,09 a 0,29) reduziu ainda mais o risco. Conclusões. O Ministério da Saúde do Suriname deve desenvolver estratégias para a detecção precoce de casos em populações-chave, tais como homens com 60 anos de idade ou mais. A implementação da terapia preventiva com isoniazida para o HIV deve ser mantida. A intensificação do tratamento de TB e HIV, preferencialmente através da supervisão, é essencial para reduzir a mortalidade por TB/HIV.


Subject(s)
Tuberculosis , HIV , Mortality , National Health Programs , Suriname , HIV , Mortality , National Health Programs , Tuberculosis , Mortality , National Health Programs
15.
Zootaxa ; 4683(4): zootaxa.4683.4.4, 2019 Oct 10.
Article in English | MEDLINE | ID: mdl-31715910

ABSTRACT

Coloration, gene-sequence data (H3, 12s, 16s), and subtle features in morphology support the description of two new species, both formerly regarded to represent accepted variants of Phimochirus holthuisi s.l. While color in life consistently separates these species from P. holthuisi s.s. and from each other, morphological distinctions are subtle and less than absolute in small specimens, being based on ventral spine counts of walking leg dactyls and relative development of the superior crest on the major chela. Molecular phylogenetic analyses clearly support the separation of sister clades, representing two new species, from P. holthuisi s.s. as well as other congeners available for analysis. Both of the new species are presently known to occur widely throughout the northern Gulf of Mexico, though one occurs more commonly in the northeastern and southeastern Gulf, and may range as far south as Suriname. The other has been taken primarily in the northwestern Gulf, and is not known from outside Gulf waters. While both of the new species appear restricted to relatively deep subtidal waters of the continental shelf, Phimochirus holthuisi s.s. is instead more commonly found in shallow nearshore tropical waters on or near coral reefs. Previous literature reports of P. holthuisi usually represent, at least in part, one or both of these two new species.


Subject(s)
Anomura , Animals , Coral Reefs , Gulf of Mexico , Mexico , Phylogeny , Suriname
16.
Zootaxa ; 4613(1): zootaxa.4613.1.2, 2019 Jun 04.
Article in English | MEDLINE | ID: mdl-31716424

ABSTRACT

Four new species of Grotea Cresson are described: Grotea goianiense Herrera-Flórez sp. n., G. paulista Herrera-Flórez sp. n. and G. amazonensis Herrera-Flórez sp. n. from Brazil and G. surinamese Herrera-Flórez sp. n. from Suriname. An identification key to Brazilian and Suriname species of this genus is given. New descriptions for G. delicator (Thunberg 1822) and G. perplexa Slobodchikoff 1970 are provided.


Subject(s)
Hymenoptera , Animals , Brazil , Suriname
17.
Zootaxa ; 4664(2): zootaxa.4664.2.4, 2019 Sep 03.
Article in English | MEDLINE | ID: mdl-31716678

ABSTRACT

A new species of Cetopsis is described from Guiana Shield drainages in Guyana and Suriname. The new species is found in the Konawaruk River and tributaries, Essequibo River basin, Guyana, and in the Mauritie Creek, tributary to the Tempati River, upper Commewijne River basin, Suriname. The new taxon can be distinguished from all congeners by a combination of features: dark spots on sides of the body eye-sized or larger, dark, bilobed patch at the base of the caudal fin, absence of a dark humeral spot, absence of dark pigmentation along the fin-membrane posterior to the first dorsal-fin ray, dark pigmentation at the base of the dorsal fin, dark spots extending ventrally to the bases of anal-fin rays, and 41 total vertebrae with 28 caudal vertebrae. Data on internal anatomy of the new species were incorporated into a previously-published phylogenetic analysis and resolves the position of the new species as the sister group of C. motatanensis, from Lago Maracaibo basin. The new Cetopsis is the first species of the genus known to occur exclusively in the Guiana Shield.


Subject(s)
Catfishes , Animals , Guyana , Phylogeny , Rivers , Suriname
18.
Zootaxa ; 4664(1): zootaxa.4664.1.4, 2019 Sep 02.
Article in English | MEDLINE | ID: mdl-31716689

ABSTRACT

Chrysomydas Wilcox, Papavero Pimentel, 1989 (Diptera, Mydidae, Mydinae, Stratiomydina), is a poorly known monotypic genus, with the type-species, C. nitidulus (Olivier, 1811), recorded from Brazil, French Guiana, Guyana, and Suriname. The present work aims to provide an updated diagnosis for the genus and type-species, C. nitidulus, along with the description of C. phoenix Calhau Lamas sp. nov. from the state of Rio de Janeiro, Brazil, based on a male imago and associated pupal exuviae. Additionally, the first bionomic data for the genus are reported, with the rearing of adult C. nitidulus in the laboratory from larvae collected under the decaying trunk of a coconut palm (Cocos nucifera L.) in the state of Amazonas, Brazil. The new species is easily distinguished from C. nitidulus by the predominantly black tergal and scutal setulae, which are golden in the type-species. They also differ by the male genitalia and shape of the proboscis.


Subject(s)
Diptera , Animals , Brazil , French Guiana , Guyana , Male , Suriname
19.
Zootaxa ; 4648(3): zootaxa.4648.3.7, 2019 Jul 31.
Article in English | MEDLINE | ID: mdl-31716939

ABSTRACT

The Syrphidae genus Domodon Reemer, 2013 so far included two species, D. zodiacus Reemer, 2013 and D. peperpotensis Reemer, 2014, both recorded only from Suriname. Additional specimens belonging to this genus have been collected in many other localities in South and Central America. In this paper, the genus is revised and three new species are described: D. caxiuana sp. nov. (northern South America), D. inaculeatus sp. nov. (northern South America), and D. sensibilis sp. nov. (Costa Rica). The distribution of D. peperpotensis is extended to include French Guiana. Photographs of the type material of the new species and illustrations of male genitalia of all species are provided, as well as a key to species.


Subject(s)
Diptera , Animal Distribution , Animals , Central America , Costa Rica , French Guiana , Male , North America , South America , Suriname
20.
Rev Panam Salud Publica ; 43, November 2019
Article in English | PAHO-IRIS | ID: phr-51665

ABSTRACT

[ABSTRACT]. Objective. To identify factors associated with sputum smear nonconversion in patients with pulmonary tuberculosis (PTB) in Suriname. Methods. A case-control study was conducted using routinely-collected surveillance data of PTB cases reported in January 2010 – December 2015 and recorded in the database of the National Tuberculosis Program of Suriname. Cases were smear-positive PTB patients whose sputum results were negative 2 months after treatment initiation. Controls were the smear-positive PTB patients whose sputum results were negative in the same timeframe. Multivariate logistic regression analysis was used to examine associations between potential risk factors and smear conversion. Results. The two age groups ≥ 35 years (35 – 54 years, AOR: 2.7, 95%CI: 1.2 – 6.1; and 55+ years, AOR: 2.5, 95%CI: 1.1 – 5.9) and high bacillary load at baseline (AOR 2.34, 95%CI: 1.2 – 4.8) were significantly associated with delayed smear conversion. Conclusion. The National TB program of Suriname should develop strategies to address patients at higher risk for delayed smear conversion to prevent further spreading and unfavorable treatment outcomes. To better inform decision-making and future studies, the NTP should expand its data collection to include all risk factors for delayed smear conversion.


[RESUMEN]. Objetivo. Determinar los factores relacionados con la falta de conversión de la baciloscopia en pacientes con tuberculosis pulmonar (TBP) en Suriname. Métodos. Se llevó a cabo un estudio de casos y testigos con datos de vigilancia sistemática de la base de datos del programa nacional contra la tuberculosis de Suriname, se analizaron los casos de TBP notificados desde enero del 2010 hasta diciembre del 2015. Los casos fueron pacientes con TBP y baciloscopia positiva inicial cuyo resultado se volvió negativo al cabo de 2 meses del inicio del tratamiento. Los controles fueron pacientes con TBP y baciloscopia positiva inicial que presentaron resultados negativos de la baciloscopia durante el mismo período. Se usó un análisis de regresión logística multivariante para examinar las asociaciones entre los posibles factores de riesgo y la conversión de la baciloscopia. Resultados. Los grupos etarios de mayores de 35 años (35-54 años, ORA, 2,7, IC 95 %: 1,2-6,1; y mayores de 55 años, ORA, 2,5, IC 95 %: 1,1-5,9) con carga bacilar elevada al inicio del estudio (ORA, 2,34, IC 95 %: 1,2-4,8) presentaron una asociación significativa con retraso de la conversión de la baciloscopia. Conclusiones. El programa nacional contra la tuberculosis de Suriname debe plantear estrategias para atender a los pacientes con un riesgo más alto de retraso de la conversión de la baciloscopia a fin de prevenir una mayor propagación de la enfermedad y resultados desfavorables del tratamiento. Este programa debe ampliar la recopilación de datos para incluir todos los factores de riesgo de retraso de la conversión de la baciloscopia y de esta manera fundamentar mejor la toma de decisiones y los estudios futuros.


[RESUMO]. Objetivo. Identificar os fatores associados à não conversão da baciloscopia de escarro em pacientes com tuberculose pulmonar no Suriname. Métodos. Estudo de caso-controle conduzido baseado em dados de vigilância coletados rotineiramente de casos de tuberculose pulmonar notificados em janeiro de 2010 a dezembro de 2015 e registrados na base de dados do Programa Nacional de Combate à Tuberculose do Suriname. Os casos foram pacientes com tuberculose pulmonar com baciloscopia positiva cujos resultados ficaram negativos em dois meses após o início de tratamento. O grupo de controle foi formado por pacientes com tuberculose pulmonar e baciloscopia positiva inicial cujos resultados foram negativos no mesmo período. Uma análise de regressão logística multivariada foi realizada para examinar as associações entre os fatores de risco em potencial e a conversão da baciloscopia. Resultados. Idade de 35 anos ou mais (35 a 54 anos, OR ajustado 2,7, IC 95% 1,2–6.1; e 55 anos ou mais, OR ajustado 2,5, IC 95% 1,1–5,9) e alta carga bacilar inicial (OR ajustado 2,34, IC 95% 1,2–4,8) tiveram associação significativa com a conversão tardia da baciloscopia. Conclusões. O Programa Nacional de Combate à Tuberculose do Suriname deve elaborar estratégias para contemplar os pacientes com maior risco de conversão tardia da baciloscopia para evitar propagar mais a doença e prevenir desfechos desfavoráveis no tratamento. Para subsidiar melhor a tomada de decisão e estudos futuros, o Programa de Tuberculose deve expandir a coleta de dados para abranger os fatores de risco para conversão tardia da baciloscopia.


Subject(s)
Tuberculosis , Tuberculosis, Pulmonary , Treatment Outcome , Sputum , Risk Factors , Suriname , Tuberculosis, Pulmonary , Treatment Outcome , Sputum , Risk Factors , Tuberculosis, Pulmonary , Sputum , Treatment Outcome , Risk Factors , Tuberculosis
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